A sensitive and specific assay for the serological diagnosis of antilaminin 332 mucous membrane pemphigoid.

BACKGROUND: Antilaminin 332 mucous membrane pemphigoid (MMP) is an autoimmune subepidermal blistering disease with predominant mucosal involvement and autoantibodies against laminin 332. Malignancies have been associated with this disease; however, no standardized detection system for antilaminin 332 serum antibodies is widely available. OBJECTIVES: Development of a sensitive and specific assay for the detection of antilaminin 332 antibodies. METHODS: An indirect immunofluorescence (IF) assay using recombinant laminin 332 was developed and probed with a large number of antilaminin 332 MMP patient sera (n = 93), as well as sera from patients with antilaminin 332-negative MMP (n = 153), bullous pemphigoid (n = 20), pemphigus vulgaris (n = 20) and noninflammatory dermatoses (n = 22), and healthy blood donors (n = 100). RESULTS: In the novel IF assay, sensitivities with the laminin 332 heterotrimer and the individual α3, ß3 and γ2 chains were 77%, 43%, 41% and 13%, respectively, with specificities of 100% for each substrate. The sensitivity for the heterotrimer increased when an anti-IgG4 enriched antitotal IgG conjugate was applied. Antilaminin 332 reactivity paralleled disease activity and was associated with malignancies in 25% of patients with antilaminin 332 MMP. CONCLUSIONS: The novel IF-based assay will facilitate the serological diagnosis of antilaminin 332 MMP and may help to identify patients at risk of a malignancy.

[Specificities in children wound healing]. / Particularités de la cicatrisation de l'enfant.

Children have specific characteristics of wound healing. The aim of this study was to describe the specific clinical characteristics of wounds healing in children and to present the current knowledge on the specific mechanisms with regard to infant age. The tissue insult or injury in fetus can heal without scar, mainly due to reduced granulation tissue associated to diminished or even no inflammatory phase, modified extracellular matrix such as the concentration of hyaluronic acid in amniotic liquid, expression and arrangement of collagen and tenascin. Thickness of children skin is a serious negative factor in case of trauma, whereas poor co-morbidities and efficient growth tissue mechanisms are beneficial to good evolution, even in cases of extensive damage and loss of tissue. The subsequent tissue mechanical forces, wound healing during childhood, spanning from the age of 2 until the end of puberty, is associated with more hypertrophic scars, both in duration and in intensity. Consequently, unnecessary surgery has to be avoided during this period when possible, and children with abnormal or pathologic wound healing should benefit from complementary treatments (hydration, massage, brace, silicone, hydrotherapy…), which represent efficient factors to minimize tissue scarring. After wound healing, the growth body rate can be responsible for specific complications, such as contractures, alopecia, and scar intussusceptions. Its evolutionary character implies the need of an attentive follow-up until adult age. Psychologic repercussions, as a consequence of pathologic scars, must be prevented and investigated by the surgeon.

Effectiveness of infliximab in pityriasis rubra pilaris is associated with pro-inflammatory cytokine inhibition.

BACKGROUND: Pityriasis rubra pilaris (PRP) is a rare inflammatory skin disease. Recently, the use of anti-TNF-α in treating resistant forms of PRP has been reported. OBJECTIVES: To evaluate the clinical efficacy of infliximab in the treatment of PRP along with the evolution of secretion of some serum cytokines during treatment. METHODS: Patients presenting widespread PRP were included consecutively and treated with infliximab. We compared cytokine profiles (notably CXCL-10 and TNF-α) by ELISA in sera from both patients with PRP and controls (healthy/psoriasis) at the time of diagnosis and after clinical remission (PRP). RESULTS: 4 patients were treated with infliximab and achieved complete remission without any recurrence after treatment ending. The serum level of TNF-α and CXCL-10 was increased at the time of inclusion and normalized after treatment. Analysis of the typical component of the T helper cell 1 (Th1) and Th2 cytokine network did not show modification. CONCLUSION: Infliximab is an effective treatment of PRP. The analysis of the cytokine profile is in agreement with an absence of further recurrence of PRP by an early and unique inflammatory mechanism without significant underlying autoimmunity.

Effect of electroacupuncture on brachial plexus post-traumatic neuralgia: A case report.

Background: Brachial plexus injury is a serious peripheral nerve injury that severely disables upper limbs and affects patients' daily life and work Acupuncture and Electroacupuncture have traditionally been used to treat neuropathic pain. However, there is still lacking evidence as regard to their effects on pain following traumatic nerve and plexus lesions. Neurotmesis after brachial plexus injury also causes movement disorders of the denervated muscles and loss of sensory function in the skin. Case report: We report a case of a brachial plexus injury due to humeral fracture, predominantly involving the lower trunk and the medial cord, treated with electroacupuncture. Results. We documented a positive significant response, based on clinical examination, pain scores and neurophysiologic findings. Conclusions: Repeated Electroacupuncture can relieve neuropathic pain due to brachial plexus injury. However, additional studies are needed to verify the efficacy and effectiveness of this approach.

CXCL10 reduces melanoma proliferation and invasiveness in vitro and in vivo.

BACKGROUND: Melanoma is often infiltrated by inflammatory and immune cells that might either maintain chronic inflammation, therefore promoting tumour growth, or mount an antitumour response to control tumour outcome. In this setting, Th1-oriented lymphocyte infiltration is associated with a better outcome in melanoma. Although the interferon-induced protein CXCL10 is expressed by Th1 immune cells, its receptor was also shown to be involved in melanoma progression and metastasis. OBJECTIVES: To investigate the CXCL10-mediated antitumoral response in vivo, and its clinical relevance. Methods C57BL/6 mice bearing B16F1 melanoma were treated intraperitoneally with an adenovirus vector expressing CXCL10. In addition, peripheral blood mononuclear cells (PBMC) from 20 patients, 10 with melanoma in remission and 10 with melanoma in progression, were assessed for their cytokine/chemokine content using a 30-plex assay, and for their ability to modulate melanoma invasion in vitro in Transwell(®) (Sigma-Aldrich) chambers coated with Matrigel(®) (BD Biosciences). RESULTS: Treatment with CXCL10 reduced melanoma tumour growth in C57BL/6 mice compared with controls in vivo, and reduced melanoma invasion in vitro. Screening for expression of 30 cytokine/chemokine proteins showed that only CXCL10 was significantly increased in patients in remission compared with patients in progression. PBMC only from patients in remission significantly reduced melanoma cell invasiveness in an ex vivo Transwell(®) assay. Accordingly, this inhibitory effect was also observed with PBMC culture media from patients with melanoma in remission. CONCLUSIONS: The quantitative increase in CXCL10 production, together with its ability to limit melanoma progression, shows the potential benefit of this chemokine to control melanoma progression or metastasis.

[Long-term survival and spontaneous tumor regression in stage IV melanoma: possible role of adrenalectomy and massive tumor antigen release]. / Survie prolongée et régression tumorale spontanée au cours d'un mélanome de stade IV: rôles possibles de la surrénalectomie et de la libération massive d'antigènes tumoraux.

BACKGROUND: Mean survival for stage IV melanoma patients is 6 to 8 months. Long-term survival is rare and spontaneous regression even more unusual. PATIENTS AND METHODS: A 46-year-old woman underwent amputation of the left thumb for subungual melanoma in 1997. In 2002, lobectomy was performed for a single pulmonary metastasis. In June 2006, a seemingly isolated adrenal metastasis was detected, and was rapidly complicated by acute abdominal symptoms due to metastatic rupture that required emergency adrenalectomy. During surgery, peritoneal metastases were observed macroscopically and confirmed histologically. One month later, then every six months until July 2009, clinical and laboratory tests, and in particular positron emission tomodensitometry (PET) scans, revealed no further tumoural lesions. No treatment was given. Screening for signs of autoimmunity revealed isolated appearances of anticardiolipin antibodies starting in June 2006. DISCUSSION: This rare case suggests the existence of specific factors resulting in tumour control. The favourable prognostic value of autoimmune signs has been discussed in stage III and IV melanoma. A number of studies have also suggested a link between prolonged survival and adrenalectomy for single and multiple adrenal metastases, with rare cases of complete regression of residual tumour following non-oncological surgery, as occurred in our patient. Other possible mechanisms include massive release of tumour antigens following metastatic rupture possibly resulting in massive stimulation of antitumour immune response, as suggested in certain animal models. Laboratory tests to validate these hypotheses have been indicated and could open up fresh therapeutic horizons.

[Updates in systemic sclerosis pathogenesis: Toward new therapeutic opportunities]. / Actualités dans la physiopathologie de la sclérodermie systémique : vers de nouvelles opportunités thérapeutiques.

Systemic sclerosis is a rare connective tissue disease characterized by skin and several internal organ fibrosis, systemic vasculopathy and immune abnormalities. Even if fibroblasts and endothelial cells dysfunction, as well as lymphocytes and other immune cells implication are now well described, the exact origin and chronology of the disease pathogenesis remain unclear. Oxidative stress, influenced by genetic and environmental factors, seems to play a key role. Indeed, it seems to be implicated in the early phases of fibrosis development, vasculopathy and in immune tolerance abnormalities shared by all patients, although disease expression is heterogeneous. To date, no curative treatment is available. Even if immunosuppressive treatment or drugs acting on vascular system are proposed for some patients, overall, treatment efficiency remains modest. Only autologous hematopoietic stem cells transplantation, reserved for patients with severe or rapidly progressive fibrosis, has recently demonstrated efficiency, with lasting regression of fibrosis. Nevertheless, this treatment can expose to important, life-threatening toxicity. In the last decade, new mechanisms implicated in the pathogenesis of systemic sclerosis have been unraveled, bringing new therapeutic opportunities. In this review, we offer to focus on recent insights in the knowledge of systemic sclerosis pathogenesis and its implication in current and future medical care.

Elastolysis induces collagenolysis in a gingival lamina propria model.

Elastin peptides were previously reported to increase MMP expression in several cell types. We found binding of these peptides to their receptors led to enhanced MMP-3 and MMP-1 expression, but not activation, in human gingival fibroblasts cultured on plastic dishes. We hypothesized that these peptides, in a more physiological environment, might additionally trigger an MMP-3/MMP-1 activation cascade, leading to matrix lysis, as occurs in periodontitis. To test this hypothesis, we used contracted and attached lattices as gingival lamina propria equivalents. In such 3D models, supplementation of elastin peptides and plasminogen triggered an MMP-3/MMP-1 activation cascade and significant down-regulation of TIMPs production, further leading to intense collagen degradation. We propose that elastolysis, as occurs in periodontitis, potentiates collagenolysis, thus promoting disease progression.

Control by thyrotropin of the production by thyroid cells of an inositol phosphate-glycan.

The increased turnover of phosphatidylinositol promoted by thyrotropin (TSH) in pig thyroid tissue does not seem to be caused by an increased production of inositol tris-phosphate. We have explored another possibility, the synthesis of an inositol phosphate-glycan (IP-gly). Our results show that thyroid cells in culture produced this substance from a precursor phosphatidylinositol-glycan (Gly-PI). The obtained IP-gly seemed, by its analytical and biological properties, to be identical, or similar, to the previously described insulin mediator.

Characterisation of gamma-glutamylcysteine synthetase-heavy subunit promoter: a critical role for AP-1.

The 5'-flanking region of human gamma-glutamylcysteine synthetase-heavy subunit (gamma-GCS-HS) was characterised by creating a series of chloramphenicol acetyl transferase (CAT) reporter deletion constructs. Analysis of various deleted CAT constructs revealed that a putative AP-1 consensus sequence is required to direct the constitutive and oxidant-mediated promoter activity. Gel mobility shift and mutation analysis of the sequence (-269 to -263 bp), showed binding of AP-1 is involved in the oxidant-mediated regulation of gamma-GCS-HS promoter activity.

Production of lipocortin-like proteins by cultured human tracheal submucosal gland cells.

Evidence is obtained for the presence of lipocortin-like proteins in human tracheal gland cells in culture. Using polyclonal antibodies to lipocortin I, indirect immunofluorescence studies demonstrate that lipocortin I is mainly confined to the tracheal gland cell surface. From cell membranes, four Ca2(+)-dependent proteins (35, 40, 45 and 67 kDa) were identified as lipocortin related proteins by using immunoblotting and fluorography following [35S]methionine metabolic labeling experiments. A strong immunoreactivity for the 35 kDa protein was observed. In addition, lipocortin-like proteins with apparent Mr33, 35, 37 and 67 kDa, respectively, were released in the apical culture medium by tracheal gland cells cultured on microporous membrane of a double chamber culture system.

Purification and characterization of phospholipase A2 inhibitory proteins from pig thyroid gland.

A 32 kDa phospholipase A2 inhibitory protein was isolated from pig thyroid gland after calcium precipitation and fast protein liquid anion-exchange chromatography. SDS-polyacrylamide gel electrophoresis revealed the purity of the protein. The protein activity was assessed by the inhibition of pancreatic phospholipase A2 on [3H]oleic acid-labelled Escherichia coli membranes as substrate and on the prostaglandin E2 production of cultured thyroid cells. The amino acid composition and the isoelectric point were quite similar to those of endonexin previously described in other tissues or cells. The cross-reactivity of a polyclonal antibody against a 32 kDa lipocortin from human peripheral blood mononuclear cells with our thyroidal 32 kDa protein confirmed its lipocortin nature. Before the purification by fast protein liquid chromatography, the Ca2+ pellet contained lipocortin I (35 kDa and its core protein 33 kDa) identified by its cross-reactivity with a polyclonal antibody.

Identification of four lipocortin proteins and phosphorylation of lipocortin I by protein kinase C in cytosols of porcine thyroid cell cultures.

Four proteins of the lipocortin family, lipocortin I (35 kDa), lipocortin II (36 kDa), lipocortin V (32 kDa) and lipocortin VI (67-70 kDa), were identified in the cytosols of 2-day-old cultures of thyroid cells. Only lipocortin I was phosphorylated in vitro in fully differentiated, thyroid stimulating hormone-treated cells (0.1 mU/ml). Protein kinase C was the only kinase activity which phosphorylated lipocortin I. Phosphorylation shifted its pI from 6.9 to 6.6. The in vitro phosphorylation of lipocortin I was impaired in cultures exposed for 2 days to phorbol ester (10(-7) M), although it was present in both the cytosol and the particulate fraction of these cells.

Annexin A1 processing is associated with caspase-dependent apoptosis in BZR cells.

Annexins are widely distributed and have been described in lung as well as in other cells and tissues. Annexin I (ANX AI) is a member of the calcium-dependent phospholipid binding protein family. Besides its anti-inflammatory function, ANX AI has been involved in several mechanisms such as the Erk repression pathway or apoptosis. To investigate the role of ANX AI on apoptosis in broncho-alveolar cells, we have constructed a plasmid containing the ANX AI full length cDNA. Transfected BZR cells displayed a higher level of both forms of ANX AI (37 and 33 kDa) as well as a decrease in cell viability (two-fold versus cells transfected with an empty vector). In order to analyse the endogenous ANX AI processing during stimulus-induced apoptosis, BZR cells were treated with a commonly used inducer, i.e. C2 ceramides. In these conditions, microscopic analysis revealed chromatin condensation in dying cells and the Bcl-2, Bcl-x(L)/Bax mRNA balance was altered. Caspase-3 is one of the key executioners of apoptosis, being responsible for the cleavage of many proteins such as the nuclear enzyme poly(ADP-ribose) polymerase (PARP). We demonstrate that caspase-3 was activated after 4 h treatment in the presence of ceramide leading to the cleavage of PARP. Dose-response experiments revealed that cell morphology and viability modifications following ceramide treatment were accompanied by an increase in endogenous ANX AI processing. Interestingly, in both ceramide and transfection experiments, the ANX AI cleaved form was enhanced whereas pre-treatment with the caspase inhibitor Z-VAD-fmk abolished ANX AI cleavage. In conclusion, this study demonstrates a complex regulatory role of caspase-dependent apoptosis where ANX AI is processed at the N-terminal region which could give susceptibility to apoptosis upon ceramide treatment.

Apocynin increases glutathione synthesis and activates AP-1 in alveolar epithelial cells.

Apocynin (4-hydroxy-3-methoxy-acetophenone) is a potent intracellular inhibitor of superoxide anion production in neutrophils. In this study, we studied the effect of apocynin on the regulation of the antioxidant glutathione (GSH) and activation of the transcription factor AP-I in human alveolar epithelial cells (A549). Apocynin enhanced intracellular GSH by increasing gamma-glutamylcysteine synthetase activity in A549 cells. Apocynin also increased the expression of gamma-GCS heavy subunit mRNA. This was associated with increased AP-1 DNA binding as measured by the electrophoretic mobility shift assay. These data indicate that apocynin displays antioxidant properties, in part, by increasing glutathione synthesis through activation of AP-1.

Cyclic AMP regulation of annexins I, II, V synthesis and localization in cultured porcine thyroid cells.

Porcine thyroid cells cultured in the presence of TSH (0.1 mU/ml) or forskolin (10(-5) M) for 4 days display an increased annexin I, II, V biosynthesis when compared with unstimulated cells. Annexin I mostly accumulates in the cytosolic fraction and annexins II and V in the particulate fraction. TSH and forskolin affect in the same manner annexin biosynthesis and localization. In the TSH and forskolin treated cells PGE2 production is very low in comparison with the very high PLA2 activity observed in the dedifferentiated control cells. A strong inhibition of the PGE2 production is observed in control cells incubated with a purified annexin V preparation. These results suggest the existence, in porcine thyroid cells, of a cross-talk between the adenylyl cyclase system and the phospholipase A2 mediated pathways. Annexins' biosynthesis and localization are under the control of the adenylyl cyclase system and participate in this cross-talk.

Activation of adenylate cyclase in rat fat cells promotes an increase in GTP content which controls the enzyme activity.

In previous studies, we demonstrated that the treatment of adipocytes with cholera toxin or Bordetella pertussis toxin (IAP) promoted an increase in the total guanosine triphosphate (GTP) content of the cells concomitant with the increase in cyclic adenosine monophosphate (AMP) level and the resulting lipolysis. In the present studies, we show that the acute challenge of fat cells with 1 microM isoproterenol (IPNE) is associated with a transient increase in GTP level (3-fold in 6 min). This increase may be attributed to an inhibition of the disposal of GTP or to a stimulation of its synthesis. To evaluate the actual role of GTP, we used virazole, an antitumor agent which inhibits inosinic acid dehydrogenase. After 2 h preincubation of the cells with 1 mM virazole, the effect of a 6 min challenge with 1 microM IPNE is decreased by 59% at the GTP level and by 42% in cyclic AMP production. One hour later, the resulting lipolytic efficiency is reduced by 57%. IAP treatment (10 micrograms/ml) produced its maximal effect on GTP and cyclic AMP levels and on lipolysis after 90 min incubation. The antilipolytic effect of 1 microM phenylisopropyladenosine (PIA) is almost abolished. When 1 mM virazole is added to the cell suspension to deplete the guanyl nucleotide pool, the resulting lipolysis due to IAP treatment is decreased by 85%, whereas GTP and cyclic AMP levels were decreased by 80 and 70%, respectively. We can conclude that the cyclic AMP synthesis in intact cells is accompanied by a parallel increase of their GTP content, whether the stimulation results from the activation of Gs or the inhibition of Gi. The reduction of the guanyl nucleotide pool under virazole results in a relatively less important inhibition of lipolysis when Gs is stimulated than when it is Gi.

Lutropin receptor and thyrotropin receptor share a common epitope.

In the present work, using an immunological approach, we have investigated the existence of common epitopes between two receptors of the glycoprotein hormone family, lutropin (LH) and thyrotropin (TSH) receptors. We have immunized high responder mice with purified porcine LH receptors obtained by successive affinity chromatographies on agarose-human chorionic gonadotropin (hCG) gels. From one fusion of splenocytes with the murine myeloma NSC1, secreting hybridomas were tested for their anti-LH receptor specificities. During sequential selection for this activity including direct recognition of the purified LH receptors in dot-blot assays and displacement experiments of 125I-pLH and 125I-hCG binding to different sources of receptors, we performed a parallel investigation of their anti-porcine TSH receptor activities. Purified immunoglobulins from two of them showed a TSH-like activity on the iodide metabolism of porcine thyroid cell, this activity being related to the phosphoinositide breakdown pathway; moreover, these antibodies obtained after immunization with porcine LH receptors were able to immunopurify human TSH receptors. The double selection process led us to characterize three groups of immunoglobulins: exclusive specificities for lutropin receptors or thyrotropin receptors and cross-reactive specificities. Our results demonstrate the possibility of sequence homologies at the protein and the gene levels between the receptors for the glycoprotein hormone family supporting the hypothesis of a common origin in evolution.

Modulation by cyclic AMP of arachidonic acid-induced platelet desensitization.

We have previously demonstrated that arachidonic acid (AA) and the stable cyclic endoperoxide analogue (U46619) desensitize human platelets at a common site, which is sensitive to endoperoxides/thromboxane receptor antagonists. We now report on the influence of agents which evaluate intracellular levels of platelet adenosine 3',5'-cyclic monophosphate (cAMP) on AA- and U46619-induced platelet desensitization. Prostaglandin E1, prostacyclin, carbacyclin, forskolin or dibutyryl cAMP prevented platelet activation by and desensitization to AA and to U46619 under conditions where the formation of thromboxane B2 was not significantly modified. Inhibition of platelet activation (aggregation and secretion) required a lower increase of the cAMP content than was needed to inhibit desensitization, confirming previous findings that desensitization to and by AA or U46619 are independent from the platelet release reaction. Together, these results indicate that AA-induced desensitization can be modulated by the adenylate cyclase/cAMP system acting at a site distinct from the known mechanisms of Ca2+ sequestration. This site is shared by the AA metabolite responsible for desensitization and by U46619 and is related to their common platelet membrane receptor.